Outcome of trabeculectomy with mitomycin C in patients with advanced glaucoma (original) (raw)
Related papers
Use of Mitomycin-C in Failed Trabeculectomy and High Risk Glaucoma
Pak J …, 2009
To compare the results of simple trabeculectomy with trabeculectomy using Mitomycin-C (MMC) intraoperatively. Material and Methods: This is hospital based descriptive study conducted at the Department of Ophthalmology Chandka Medical College & Hospital Larkana. 50 eyes of 37 patients were selected from glaucoma clinic conducted once a week. After history and complete ocular examination the clinical diagnosis of failed trabeculectomy and high risk glaucoma was established. During the surgical procedure patients were divided into two groups (test group and control group). The twenty five eyes underwent trabeculectomy with Mitomycin-C (MMC) 0.04% for duration of 3 minutes (test group), 25 eyes underwent primary trabeculectomy (control group). Followup period of 6 months was observed in both the groups. The span of study was from January 2006 to December 2007. Results: In this hospital based descriptive study 23 (62.16%) patients were male and 14 (37.83%) patients were female in both groups and mean age of patients in the test group 33.4 years and in control group were 24.4 years. Mean preoperative IOP in the test group was 34.6mmHg (range 20-62mmHg) while in the control group was 30.7mmHg (range 20-45mmHg) and mean postoperative IOP was 17.4 mmHg (range 10-36mmHg) in test group while in control group it was 21.3mmHg (range 11-46 mmHg). Mean IOP lowering was significantly greater in test group than that of control group. Also the number of patients taking adjunctive anti glaucoma medication to control IOP was greater in the control group than in the test group. Conclusion: Mean IOP lowering effect was statistically (P < .05) significantly greater in the test group with the use of MMC intraoperatively.
Mean Change in Intra-Ocular Pressure in patients undergoing Trabeculectomy with Mitomycin C
Pakistan Journal of Medical and Health Sciences
Aim: To examine the outcomes of trabeculectomy followed by mitomycin C in term of mean change in intra-ocular pressure in patients presented with primary congenital glaucoma. Study design: Cross-sectional/observational Place and duration of study: Department of Ophthalmology, Khawaja Muhammad Safdar Medical College, Allama Iqbal Memorial Teaching Hospital, Sialkot from 7th July 2020 to 6thJanuary 2021. Methods: Fortypatients of both genders with ages up to 5 years presented with primary congenital glaucoma were enrolled in this study. Patients demographics were recorded after taking written consent from parents/guardians. All the patients were receivedtrabeculectomy with 0.4mg/ml Mitomycin C was applied below the flap for 2 to 3 minutes. Intraocular pressure was examined preoperatively and at 12th day after surgery. Results:Twenty-four (60%) were males while 16 (40%) were females. 30 (75%) patients were ages <2yearsand 10 (25%) patients had ages >2 years. A significant differe...
Outcome of trabeculectomy with intraoperative mitomycin C for uveitic glaucoma
Canadian Journal of Ophthalmology, 2007
The purpose of this study was to compare the outcomes of mitomycin C (MMC)-augmented trabeculectomy in glaucoma patients with uveitis to those without uveitis but with other high-risk characteristics. Methods: A retrospective comparative cohort analysis consisting of 51 eyes of 51 patients (21 uveitic patients and 30 nonuveitic patients) was performed. Two outcome classifications were analyzed: absolute success (intraocular pressure [IOP] ≤ 30% baseline without glaucoma medications or 5-fluorouracil (5-FU) injections), and qualified success (IOP ≤ 30% baseline with glaucoma medications or 5-FU injections).
Trabeculectomy with mitomycin C in glaucoma associated with uveitis
Ophthalmic surgery
Twenty-four trabeculectomies performed in 24 patients for control of uveitic glaucoma were retrospectively evaluated to analyze the effect of intraoperative application of mitomycin C (MMC) on the short-term outcome of trabeculectomy for glaucoma associated with uveitis. Success rates, postoperative levels of intraocular pressure (IOP), and complications were studied. After a mean follow up of 9.87 months (range, 3 to 27 months), 18 eyes (75%) achieved an IOP of 21 mm Hg or less without antiglaucoma medications. The same IOP level with one antiglaucoma medication was achieved in four eyes (16.6%). Statistical analysis demonstrated a significant reduction in IOP postoperatively during the period studied (P = .0001). Complications observed included exacerbation of the uveitis (12.5%), choroidal detachment (12.5%), hypotony (8.3%), postoperative shallow anterior chamber (4.2%), wound leak (4.2%), hyphema (4.2%), and macular edema (4.2%). The results of this retrospective and uncontroll...
International Journal of Ophthalmology, 2022
• AIM: To determine the long-term postoperative outcomes of deep sclerectomy-trabeculectomy (DST) with mitomycin C (MMC) in the treatment of glaucoma. • METHODS: Patients who underwent DST with MMC between 2010 and 2017 were included in this retrospective observational study. Complete success was defined as postoperative intraocular pressure (IOP) ≤21 mm Hg or 30% reduction of IOP from baseline without any topical IOP-lowering agent, and qualified success defined as IOP≤21 mm Hg or 30% reduction of IOP from baseline with/without single topical agent. We evaluated the surgical success rates and complication rates of this procedure, as well as described the IOP profiles, best corrected visual acuity (BCVA) profiles and mean deviations (MD) of Humphrey visual field (HVF) 24-2 performance at each follow-up time point. Mixed linear regression models were constructed to determine estimated predictive values of demographic data, use of topical IOPlowering agents, baseline and postoperative IOP and optical profiles (e.g., BCVA and MD). • RESULTS: Totally 98 eyes (mean postoperative followup 67.5mo) showed mean IOP reduction at every followup interval. Both median BCVA and MD of visual fields were maintained throughout the follow-up intervals when comparing to baseline. The number of IOP-lowering medications decreased from 2.8±0.8 to 0.3±0.7 (P=0.068). Totally 84 (85.7%) eyes achieved complete success at final follow-up. Transient hyphaema and transient choroidal effusion developed in 15 eyes (15.3%) and 11 eyes (11.2%) respectively. Other complications included shallow anterior chamber in 5 eyes (5.1%), bleb leak in 4 eyes (4.1%), bleb revision in 7 eyes (7.1%), bleb needling in 9 eyes (9.2%) and repeat trabeculectomy in 1 eye (1.0%). There was no endophthalmitis, blebitis or macular oedema. There was no significant correlation between postoperative IOP control and postoperative BCVA. • CONCLUSION: DST with MMC demonstrates effective and sustained long-term outcomes in the treatment of glaucoma with no major complication.
Success and complication rates of trabeculectomies augmented with MMC in the management of glaucoma
2010
Glaucoma unresponsive to medical treatment is managed by surgery. Augmentation with mitomycin C (MMC) is considered in patients at high risk of surgery failure. Aim: In this paper we assess and compare the success and complications of this procedure performed in the local state hospital with those of larger international centres. Methods: A retrospective study, of the surgery performed between 2003 and 2007 at St. Luke’s Hospital by one surgeon (FM), was conducted. The total number of eyes considered in this analysis was 32. Intraocular pressures and complications up to one year post-operatively were recorded. Results: The mean intraocular pressure decreased from 30mmHg pre-operatively to 18mmHg post-operatively. The mean IOP drop registered was 42%. Of the 32 eyes that underwent trabeculectomy augmented with MMC, 23 were classified as a complete success with IOP remaining below 21mmHg at 1year post-surgery. Six eyes were considered as a partial success since they had an IOP under 2...
Trabeculectomy with mitomycin-C for postkeratoplasty glaucoma: a preliminary study
1997
Aim-To investigate the eVect of trabeculectomy with and without mitomycin C in post-keratoplasty glaucoma. Methods-A retrospective study was performed on patients who underwent trabeculectomy for glaucoma after penetrating keratoplasty. 34 eyes of 32 patients were included in this study. 26 eyes received trabeculectomy with mitomycin C and eight eyes without mitomycin C. The procedure was deemed successful if the intraocular pressure was maintained below 21 mm Hg with or without use of additional antiglaucoma medication (mean follow up time 22.3 (SD 10.3) months). Results-At the last examination trabeculectomy was successful in 19 of 26 eyes (73.0%) with mitomycin C (+) and two of eight (25.0%) without (p=0.0219). When the prognosis was analysed by Kaplan-Meier curve, the mitomycin C (+) group showed a better prognosis (p=0.0182). Mean intraocular pressure and average number of glaucoma medications improved in the group with mitomycin C without severe side eVects on the graft. Graft rejection after trabeculectomy was seen in two eyes in the mitomycin C group. Final graft clarity rate was 69.2% (18/26) in the mitomycin C (+) group and 37.5% (3/8) in the mitomycin C (−) group. Complications such as persistent epithelial defect, cystoid macular oedema, choroidal detachment, leakage from bleb were seen in four eyes in the mitomycin C (+) group and in one eye in the mitomycin C (−) group. Conclusions-Trabeculectomy with mitomycin C showed better results for glaucoma following keratoplasty.
Vojnosanitetski pregled
Background/Aim. Trabeculectomy is a safe procedure which effectively reduces the intraocular pressure (IOP). IOP is the most frequent indicator of success after glaucoma surgery. The aim of this work was to evaluate the long-term pressure control in primary open-angle glaucoma (POAG) and in pseudoexfoliative glaucoma (XFG) after primary trabeculectomy without the use of mitomycin-C (MMC), 3 to 5 years after trabeculectomy. Methods. This study involved a retrospective evaluation of 332 consecutive patients (352 eyes), 174 patients (188 eyes) with POAG (mean age of 64.0 ? 8.6 years) and 158 patients (164 eyes) with XFG (mean age of 70.7 ? 8.9 years) who underwent primary trabeculectomy between January 2007 and December 2009 at the Clinic for Eye Diseases, Clinical Center of Serbia in Belgrade. A successful control of IOP was defined as achieving IOP ? 21 mmHg without medication (complete success), or with a single topical medication (qualified success). Results. According to the type ...
2022
Purpose: To compare the control of intra ocular pressure (IOP) after trabeculectomy with adjunctive use of Mitomycin-C (MMC) versus Bevacizumab. Study Design: Quasi experimental study. Place and Duration of Study: Al-Ibrahim Eye Hospital, Isra Postgraduate Institute of Ophthalmology, Karachi, from August 2017 to August 2019. Methods: One hundred and six patients of either gender, fulfilling the inclusion criteria were planned for trabeculectomy with adjunctive use of Mitomycin-C (MMC) or Bevacizumab. Each group consisted of 53 patients (53 Eyes). The patients diagnosed with Primary Open Angle Glaucoma (POAG) with IOP ˃ 21 mm Hg and not controlled with topical anti-glaucoma medication were selected. Data were analyzed by using SPSS Version 22.0. Independent sample t test was used to check significance between two drugs. Paired sample t test was used to check significance of pre and post-operative IOP. Results: Mean age of patients was 56.67±7.34 years. Mean preoperative IOP was 31.51 ± 9.66 mm Hg in MMC group and 29.21 ± 7.69 mm Hg in Bevacizumab group. At first postoperative day, mean IOP after use of MMC was 14.75 ± 9.46 mm Hg and for Bevacizumab was 15.07 ± 6.47 mm Hg (p-value 0.001). Similarly, at one year follow-up, mean IOP for MMC group was 11.26 ± 2.31 mm Hg and for Bevacizumab was 11.73 ± 2.12 mm Hg (p-value 0.001). Conclusion: There was significant reduction in IOP in both MMC and Bevacizumab groups. However, the difference between the two groups was not statistically significant at mean follow-up of one year. Key Words: Primary Open Angle Glaucoma, Mitomycin–C, Intraocular Pressure, Bevacizumab, Trabeculectomy.
Ophthalmic surgery
To describe the authors' clinical experience with intracameral tissue plasminogen activator (tPA) after glaucoma surgery. Methods: Retrospective review of medical records of all patients who received intracameral tPA after glaucoma surgery at the Doheny Eye Institute from November 4, 1992, to June 14, 1994. There were 20 tPA administrations (18 eyes of 17 patients) in doses ranging from 6 to 25 ,."g. Indication for tPA administration was decreased bleb function secondary to blood/fibrin clot in aqueous outflow pathway. Results: Tissue plasminogen activator was given after trabeculectomy (5 drug administrations) and combined cataract extraction/trabeculectomy procedures (9 drug administrations), with increased filtration in 12 (86%). There were five (36%) instances of hyphema and three (21 %) of hypotony. All hyphemas occurred after doses of 25 ,."g. Final lOP of 18 mmHg or lower and 6 mmHg or higher was achieved in 11 (92%) of 12 patients after a mean follow-up interval of 4.2 ± 4.7 months. The six remaining tPA irrigations were done in five patients after glaucoma drainage implant surgery (n = 4) or surgical/needle revision of a filtering bleb (n = 2). Conclusions: Aqueous outflow obstruction from blood/fibrin clot after glaucoma surgery may be treated effectively with intracameral tPA in doses of 6 to 25 ,."g. The authors recommend using a dose of less than or equal to 6 to 12.5 ,."g to minimize the risk of hyphema.